First-Line Treatment with Carboplatin plus nab-Paclitaxel and Maintenance Monotherapy with nab-Paclitaxel for a Thymic Carcinoma: A Case Report

Abstract

Thymic carcinomas are rare malignant tumors, located in the anterior mediastinum. For the treatment of these carcinomas, several chemotherapy regimens have been suggested, including carboplatin plus paclitaxel. However, because of the rarity of these tumors, the standard chemotherapy regimen has not yet been established. Here, we report a case of thymic carcinoma that responded to first-line carboplatin plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) therapy with continuation maintenance nab-paclitaxel monotherapy. A 78-year-old male presented to a hospital with the chief complaint of dyspnea. Cardiomegaly was detected on chest X-ray scans, and marked pericardial effusion was observed by echocardiography. Chest computed tomography scans revealed the presence of a mediastinal mass, pericardial thickening, and pericardial effusion. The serum levels of the tumor marker CYFRA 21-1 (cytokeratin-19 fragment) were elevated. Eventually, he was diagnosed with squamous cell carcinoma of the thymus, which was staged as cT4N3M0 or stage IV (according to the tumor-node-metastasis classification). Chemotherapy with carboplatin on day 1 and nab-paclitaxel on days 1, 8, and 15, every 4 weeks was initiated. After the administration of 4 cycles of this regimen, the tumor diameter appeared reduced, and the serum CYFRA 21-1 levels were normalized. After a 1-month interval, the serum CYFRA 21-1 levels increased again; therefore, maintenance nab-paclitaxel monotherapy was initiated. At the end of the treatment, the patient experienced a progression-free survival of 10.3 months. Carboplatin plus nab-paclitaxel may be an appropriate alternative first-line treatment for thymic carcinomas. Additionally, maintenance nab-paclitaxel monotherapy may prolong the progression-free survivals of patients with thymic carcinomas.

Combination carboplatin and nab-paclitaxel as a first-line treatment for advanced thymic carcinoma

“…Our retrospective study analyzed the e cacy and safety of combined carboplatin plus nab-paclitaxel therapy in 12 previously untreated patients with advanced thymic carcinoma. While previous case reports have indicated the e cacy of this combination regimen for patients with this disease [15][16][17], no cohort studies have been performed to validate these claims. To the best of our knowledge, ours is the rst study to evaluate the efficacy of combination carboplatin plus nab-paclitaxel in patients with advanced thymic carcinoma.…”

Carboplatin plus nanoparticle albumin‑bound paclitaxel for the treatment of thymic carcinoma

“…These case reports showed that the administration of carboplatin plus nab-paclitaxel resulted in favorable antitumor effects against thymic carcinoma. Funaishi et al (23) reported a case with a PFS time of 10.3 months. Ley et al (24) and Maurer et al (25) suggested the clinical benefit of nab-paclitaxel in recurrent/metastatic gynecological and head and neck carcinomas, which are resistant to paclitaxel and docetaxel.…”

Comparison of efficacy and safety of carboplatin combined with nab-paclitaxel or paclitaxel as first-line therapy for advanced thymic epithelial tumors

“…However, no studies have yet compared the efficacy and safety of PC and nab-PC for advanced thymic carcinoma. A few recent case reports evaluated the efficacy and safety of nab-PC for advanced thymic carcinoma [14][15][16][17][18] . They all demonstrated good responses to nab-PC, with three patients having PFS durations of 9.1, 13, and 10.3 months, respectively.…”